08-1150 (SOTB)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Td4t 4 4a Q"
Application Number: 08-00001150
Property Address: 52125 DAY STAR DR
APN: 767-200-999-19 -312023-
Application description: STRUCTURES OTHER THAN BUILDINGS
Property Zoning: LOW DENSITY RESIDENTIAL
Application valuation: 450
Applicant:
Architect or Engineer:
PIP
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am li nsed der provisions of Chapter 9 (commencing with
Section 7000) of Division 3 of the Business and P ofess' Is Code, and my License is in full force and effect.
Lice a Class: ract
C,J5333 License No.: 614611
Date: , qc or:
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the
following reason (Sec. 7031.5, Business and Professions Code: Any city or county that requires a permit to
construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for the
permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's State
License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or
that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by
any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).:
(_ I I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and
the structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The
Contractors' State License Law does not apply to an owner of property who builds or improves thereon,
and who does the work himself or herself through his or her own employees, provided that the
improvements are not intended or offered for sale. If, however, the building or improvement is sold within
one year of completion, the owner -builder will have the burden of proving that he or she did not build or
improve for the purpose of sale.).
(_ 1 I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec.
7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of
property who builds or improves thereon, and who contracts for the projects with a contractor(s) licensed
pursuant to the Contractors' State License Law.).
1 _ 1 I am exempt under Sec. , B.&P.C. for this reason
Date:
Owner:
CONSTRUCTION LENDING AGENCY
I hereby affirm under penalty of perjury that there is a construction lending agency for the performance of the
work for which this permit is issued (Sec. 3097, Civ. C.).
Lender's Name:_
Lender's Address:
LQPERMIT
Owner:
FIELDS RESIDENCE
52125 DAY STAR DR
LA QUINTA, CA 92253
Contractor:
MCINTYRE POOLS & S
83695 AVENUE 45
INDIO, CA 92201
(760)342-3.612
Lic. No.: 614611
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
INCJUL 2 2 2008
CITY OF U ai nwrA
Date: 7/14/08
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one of the following declarations:
_ I have and will maintain a certificate of consent to self -insure for workers' compensation, as provided
for by Section 3700 of the Labor Code, for the performance of the work for which this permit is
issued.
Y-
'1 have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor
Code, for the performance of the work for which this permit is issued. My workers' compensation
insurance carrier and policy number are:
Carrier DELOS INS CO Policy Number 01DKRM12001870
I certify that, in the performance of the work for wh�cthis permit is issued, I shall not employ any
person in any manner so as to beco subject to workers' compensation laws of California,
and agree that, if I should become ject to th rkers' compensation provisions of Section
3700 of the L or Code, I shall f hwith co p with those provisions.
ate:Z _Q plicant: '
WARNING: FAILURE TO SECURE WOR ERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
DOLLARS ($100,000). IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN
.SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
APPLICANT ACKNOWLEDGEMENT
IMPORTANT Application is hereby made to the Director of Building and Safety for a permit subject to the
conditions and restrictions set forth on this application.
1 . Each person upon whose behalf this application is made, each person at whose request and for
whose benefit work is performed under or pursuant to any permit issued as a result of this application,
the owner, and the applicant, each agrees to, and shall defend, indemnify and hold harmless the City
of La Quinta, its officers, agents and employees for any act or omission related to the work being
performed under or following issuance of this permit.
2. Any permit issued as a result of this application becomes null and void if work is not commenced
within 180 days from date of issuance of such permit, or cessation of work for 180 days will subject
permit to cancellation.
certify that I have read this application and state that the above infar tion is c r ct. I agree to comply with all
city and county ordinances and state laws relating to building constr tion, and reby authorize representatives
of t/his/cptmty to enter upon the above-mentioned property for insp -tion pu es.
ctrl e: — r? �A�urepplicant or Agent):
Application Number . . . . . 08-00001150
Permit . . .
BUILDING PERMIT
Additional desc . .
Permit Fee
15.00
Plan Check Fee
9.75
Issue Date . . . .
Valuation . . .
. 450
Expiration Date
1/03/09
Qty Unit Charge
Per
Extension
--------------------------------------------7-------------------------------
BASE FEE
15.00
Permit . . .
PLUMBING
Additional desc . .
Permit Fee . . . .
18.00
Plan Check Fee
4.50
Issue Date
Valuation . . .
. 0
Expiration Date
1/03/09
Qty Unit Charge
Per
Extension
BASE FEE
15.00
1.00 3.0000
EA PLB GAS PIPE 1-4 OUTLETS
3.00
----------------=-----7-----------------------------------------------------
Special Notes and Comments
FIREPIT PER APPROVED
PLAN
Fee summary Charged
---------------------------
Paid
----------
Credited
--------------------
Due
Permit Fee Total
33.00
.00 .00
33.00
Plan Check Total
14.25
.00 .00
14.25
Grand Total
47.25
.00 .00
47.25
LQPERMIT
Bin #
City of La Quinta..
Building U SafetyDivision '
P.O. Box 1504, 78-495 Calle Tampico
U Quidta, CA 92253 -'(7¢0) 777-7012
Building Permit Application and Tracking Sheet
Permit #
Project Address:'nc
S
Owner's Name: �� 5
A. P. Number:
Address:6- S _ ciy
Legal Description:
City, ST, Zip:
i �1.
L S
Contractor: I
Telephone:
Address: '21k.
. Project Description:.y
City, ST, Zip:' ° G - 'Z Z 3
Telephone: 34Z-3612
State Lic. # : —
City Lic. #:
Arch., Engr., Designer:
Address:
City, ST, Zip:
Telephone:
Construction Type: Occupancy:
State Lit. #:
Project type (circle one): New Add'n 'Alter Repair Demo
Name of Contact Person: J e y�
Sq. FL:
#Stories:.
# Units:
Telephone # of Contact Person: Z,5 Q
DC
Estimated Value.of Project:
APPLICANT:. DO NOT WRITE BELOW THIS LINE .
#
Submittal
Req'd
Rec'd
TRACIQMG .
PERMIT FEES
Plan Sets
Plan Check submitted
Item
Amount
Structural Calcs.
Reviewed, ready for corrections
Plan Check Deposit
Truss Calcs.
Called Contact Person
Plan Check Balance
Energy Cales.
Plans bicked up
Construction
Flood plain plan,
Plans resubmitted
Mechanical
Grading. plan
2°" Review, ready for correctionsrissue
Electrical
Subcontactor.List '
Called'ContactPerson
Plumbing
Grant'Deed
Plans,picked up
S.M.I.
H.O.A. Approval
Plans resubmitted
Grading.
IN HOUSE:-
"" Review, ready for correctionslissue
Developer Impact Fee
Planning Approval '
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees
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